[Congressional Record (Bound Edition), Volume 163 (2017), Part 2]
[House]
[Pages 2740-2752]
[From the U.S. Government Publishing Office, www.gpo.gov]




 PROVIDING FOR CONGRESSIONAL DISAPPROVAL OF FINAL RULE BY SECRETARY OF 
                       HEALTH AND HUMAN SERVICES

  Mrs. BLACK. Mr. Speaker, pursuant to House Resolution 123, I call up 
the joint resolution (H.J. Res. 43) providing for congressional 
disapproval under chapter 8 of title 5, United States Code, of the 
final rule submitted by Secretary of Health and Human Services relating 
to compliance with title X requirements by project recipients in 
selecting subrecipients, and ask for its immediate consideration.
  The Clerk read the title of the joint resolution.
  The SPEAKER pro tempore. Pursuant to House Resolution 123, the joint 
resolution is considered read.
  The text of the joint resolution is as follows:

                              H.J. Res. 43

       Resolved by the Senate and House of Representatives of the 
     United States of America in Congress assembled, That Congress 
     disapproves the rule submitted by the Secretary of Health and 
     Human Services relating to compliance with title X 
     requirements by project recipients in selecting subrecipients 
     (81 Fed. Reg. 91852; December 19, 2016), and such rule shall 
     have no force or effect.

  The SPEAKER pro tempore. The gentlewoman from Tennessee (Mrs. Black) 
and the gentlewoman from Colorado (Ms. DeGette) each will control 30 
minutes.
  The Chair recognizes the gentlewoman from Tennessee.


                             General Leave

  Mrs. BLACK. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous materials on H.J. Res. 43, currently under 
consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Tennessee?
  There was no objection.

                              {time}  1345

  Mrs. BLACK. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I rise today in strong support of my resolution of 
disapproval, H.J. Res. 43, which uses the authority of the 
Congressional Review Act to overturn the Obama administration's 11th-
hour rule forcing States like Tennessee to fund abortion providers.
  I want to begin today by stipulating very clearly what this 
resolution is about because, while I am unapologetically pro-life, you 
don't have to be in order to support this resolution. You just have to 
believe in the Tenth Amendment.
  Despite the histrionics you may hear on the other side of the aisle 
today, with today's resolution, we are not, we are not, one, voting to 
defund Planned Parenthood in any way, shape, or form; we are not voting 
to cut title X funding; and we are not voting to restrict abortion 
rights.
  Madam Speaker, we are simply voting today to affirm the rights of 
States to fund the healthcare providers that best suit their needs, 
without fear of reprisal from their own Federal Government.
  I didn't realize this was a partisan issue. It shouldn't be, because 
that is how the title X grant program functioned for more than 45 
years, until the Obama administration decided to leave this parting 
gift to abortion industry on its way out the door.
  For me, this is a personal issue. As a registered nurse, I know that 
vulnerable women seeking true comprehensive care deserve better than 
abortion-centric facilities like Planned Parenthood. So, as a State 
legislator, I worked within my authority to make sure that Tennessee 
honored the will of our pro-life populace and steered our State's share 
of title X dollars away from healthcare providers that performed 
abortion.
  As a result, our share of title X grants have been sent exclusively 
to the Tennessee Department of Health, which then allocates them to the 
county health departments and other qualified providers that protect 
the lives of the most vulnerable. That was Tennessee's right, and it 
has been able to exercise that right while protecting access to 
comprehensive care for those who are most in need.
  As a matter of fact, according to HHS' own 2015 title X Family 
Planning Annual Report, our State provided care under title X to more 
than 75,000 Tennesseeans. That means that we served even more citizens 
than the more populated States like Michigan and Virginia.
  But in December of last year, the Obama administration decided to 
intervene, setting unprecedented new parameters on how States must 
select title X grantees that were specifically designed to prop up its 
political allies in the abortion industry.
  With my resolution, I am proposing that we go back just a few short 
weeks prior to December 15, 2016, the day before the Obama 
administration decided to reconfigure this 45-year-old program with its 
ill-conceived order. That is all my resolution does is to take us back 
45 years to the way the program has operated.
  I urge my colleagues to give States the freedom and the flexibility 
to take care of their citizens the best way that they know how by 
voting ``yes'' on this H.J. Res. 43.
  Madam Speaker, I reserve the balance of my time.
  Ms. DeGETTE. Madam Speaker, I yield myself 3 minutes.
  Madam Speaker, we are not even a full month into the new Presidency. 
Yet, the President and the Republicans in Congress have already 
launched numerous attacks on women's health and access to care. Here's 
just a few of the examples aside from today.
  They are charging ahead to dismantle the Affordable Care Act without 
making any promises to preserve the vital protections for women that 
are in that bill.
  They imposed and dramatically expanded the global gag rule, which 
harms women's access to health care around the world.
  And just after the historic Women's March, House Republicans passed 
H.R. 7, an extreme bill that effectively bans private insurance 
companies from covering comprehensive healthcare services.
  But here we are again today, with another bill that threatens access 
to family planning care for millions of our most vulnerable citizens by 
attacking title X. Title X is the only Federal program dedicated solely 
to family planning, which includes a range of services that help women 
and their partners prepare for pregnancy and ensure healthy spacing 
between births.

[[Page 2741]]

  Title X helps 4 million people who are uninsured. Title X centers 
also play an important role in reducing unintended pregnancy, and title 
X centers are also major points of access in our safety net.
  Six in 10 women who go to a title X center consider it their major 
source of health care. What this rule that Republicans want to roll 
back does is it simply reinforces longstanding requirements that say 
that States cannot discriminate against providers for reasons that are 
unrelated to their qualifications to perform family planning services 
when distributing title X funding. In other words, if an organization 
provides abortions with its own private money but it qualifies for 
title X, it can still get that funding.
  Now I keep hearing from my colleagues that this violates states' 
rights, but that completely ignores how Federal programs work. 
Virtually all Federal funding opportunities require a State to adhere 
to certain standards to ensure policy goals are met, and that is 
exactly what this rule did.
  Republicans will also argue that community health centers can fill 
all the gaps created and accessed by denying these centers title X 
funding. This claim has been debunked on numerous occasions.
  For example, in 21 percent of counties with a Planned Parenthood 
center, Planned Parenthood is the only safety net provider in the area. 
That is why the nonpartisan Congressional Budget Office estimated, if 
Planned Parenthood were defunded, as many as 390,000 women would lose 
access to care, and 650,000 women would have reduced access. That is 
why repealing this rule is a serious problem.
  Just this afternoon I read a quote, and here's what it said: 
``Patients and doctors should be making the big decisions--not 
government bureaucrats.''
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Ms. DeGETTE. Madam Speaker, I yield myself an additional 30 seconds.
  Let me say that again. ``Patients and doctors should be making the 
big decisions--not government bureaucrats.''
  Who said this?
  Margaret Sanger? No.
  Cecile Richards? No.
  Hillary Clinton? No.
  The person who said this this afternoon is the Speaker of the House, 
Paul Ryan. I couldn't agree with him any more when it comes to title X 
family planning money. This should be made by patients and their 
doctors, not by bureaucrats in Washington.
  Madam Speaker, I reserve the balance of my time.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentleman from 
New Jersey (Mr. Smith), who has been a champion for life and been 
fighting for life for a long time.
  Mr. SMITH of New Jersey. I thank the gentlewoman for her 
extraordinary leadership on the life issue.
  Madam Speaker, subsidized by over $500 million taxpayer dollars each 
year, Planned Parenthood dismembers or chemically poisons a baby to 
death every 2 minutes, killing over 7 million innocent children since 
1973.
  Undercover videos in 2015 exposed, in numbing candor, several high-
level Planned Parenthood leaders nonchalantly talking about procuring 
children's organs for a price. They describe altering gruesome 
dismemberment procedures to preserve intact livers, hearts, and lungs 
from freshly killed babies.
  All of this begs the question, Madam Speaker, why are U.S. taxpayers 
giving half a billion dollars each year to Planned Parenthood?
  H.J. Res. 43 simply allows States to redirect funds away from 
abortion clinics and does not reduce funding for title X by so much as 
a penny. Those funds are just redirected to other health clinics that 
provide women's health care and don't engage in abortion.
  In mid-December, on his way out the door, former President Obama 
finalized a rule that coerces States to fund Planned Parenthood with 
their title X money.
  Prior to the Obama rule, States had chosen, five of them, to award 
title X funds to non-Planned Parenthood entities. These five States, 
Tennessee, Kansas, Oklahoma, Arkansas, and Ohio, account for nearly $16 
million in annual title X funding and serve over 279,000 individuals a 
year. These five States redirected those funds to other health clinics.
  But under the Obama rule, these State recipients are threatened with 
losing all--I say again--all of their title X support if they do not 
comply. This is the definition of coercion.
  The Obama administration essentially told States: You must use your 
family planning dollars to support abortionists, or we will take away 
your family planning dollars.
  I thank the gentlewoman for her courage, for her insight, and for 
offering this rule for our consideration today.
  Ms. DeGETTE. Madam Speaker, I yield 2 minutes to the gentleman from 
New Jersey (Mr. Pallone), the ranking member of the House Energy and 
Commerce Committee.
  Mr. PALLONE. Madam Speaker, I rise today in strong opposition to H.J. 
Res. 43. This resolution is simply another attack on women's health and 
another attempt by Republicans to limit women's access to high-quality, 
essential care.
  For decades, title X family planning program has funded grants that 
provide millions of Americans each year with access to a broad range of 
preventive health services, including contraception care and cancer 
screenings. Title X is a critical safety net for low-income women and 
teens; and for many patients, this program is their only source of 
health care.
  But the Republicans want to limit access to these services and allow 
States to discriminate against certain providers, all as part of their 
ongoing ideological crusade against abortion.
  I stress, this resolution would permit States to prohibit 
reproductive healthcare providers from participating in the title X 
program, and would allow States to block access to care if the provider 
separately performs abortions or is affiliated with health centers that 
do.
  Now, we already have seen what happens when States take actions to 
discriminate against providers in the title X program. Access goes 
down, the unintended pregnancy rate goes up, and the spread of sexually 
transmitted infections increases.
  So I would urge my colleagues to vote ``no'' on this resolution 
because Republicans should not be entitled to pick and choose providers 
in the title X program and play politics with women's health.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentleman from 
Kansas (Mr. Marshall), a freshman and a physician.
  Mr. MARSHALL. Madam Speaker, this past December, our past President 
finalized a rule requiring States to fund Planned Parenthood through 
title X funding.
  Today I rise as a cosponsor of and in support of this joint 
resolution, H.J. Res. 43, which repeals this Obama rule and allows 
States like mine, Kansas, to choose how to best allocate title X funds. 
The Obama rule is yet another example of government overreach that 
tries to force my State to fund Planned Parenthood.
  Redirecting Federal funds away from abortion providers does not 
reduce funds for other title X programs. Instead, this will allow even 
more funding available for county health departments and other public 
health clinics for family planning, sexually transmitted disease 
testing, and lifestyle choices education.
  While Planned Parenthood remains a political organization that spent 
tens of thousands of dollars in the last election to oppose pro-life 
candidates, let me stop and salute the nurses and social workers back 
home at the Barton County Health Department where I worked for years, 
and salute my fellow doctors, Dr. Perry Smith and Dr. Bill King, and 
everyone's favorite nurse practitioner, Sheila Hein, who dedicated 
themselves to helping women.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
New York (Mrs. Lowey).
  Mrs. LOWEY. Madam Speaker, I hope the women of America are watching.

[[Page 2742]]

Let there be no doubt about the actions of congressional Republicans 
and the Trump administration. They will oppose your right to make your 
own health decision and limit access to your reproductive health care 
at every available juncture.
  Rather than work to create jobs, House Republicans are helping State 
officials block women from getting contraception and other reproductive 
health services.
  Today's bill would particularly harm the neediest Americans, as it 
could deny them the opportunity to visit the health provider of their 
choice, which in many instances may be the only provider available 
within hours of their home.
  Sadly, this will be just one of the many assaults on women's rights 
in the 115th Congress.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentleman from 
Indiana (Mr. Messer), who is the chairman of our Republican Study 
Committee.
  Mr. MESSER. Madam Speaker, the Federal Government should not fund 
abortions, and it should not force States to fund them either. That is 
one reason this body recently voted to make the Hyde amendment 
permanent and governmentwide.
  The vast majority of Americans support this policy as a matter of 
conscience and agree that tax dollars should not fund abortion 
procedures. Today's bill is consistent with that principle.
  But despite the rhetoric across the aisle, the bill permits, but does 
not require, States to direct title X funds to health providers that do 
not provide abortions.
  Without this bill, States would be forced to fund the abortion 
industry by Federal bureaucrats. This is an issue of states' rights as 
well as one of conscience.

                              {time}  1400

  I am proud to support this measure, stand up for States, and defend 
life.
  I want to thank my colleague, Diane Black, for her hard work and 
leadership on getting this bill to the floor, and I urge my colleagues 
to vote for its passage.
  Ms. DeGETTE. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Florida (Ms. Castor).
  Ms. CASTOR of Florida. Madam Speaker, I thank the gentlewoman from 
Colorado for her leadership.
  For almost 50 years, a law called title X has ensured that women 
across America, no matter their station in life, can receive expert 
advice on how and when to plan their families, on contraceptives, and 
also receive breast and cervical cancer screenings.
  It is smart public policy. It often allows women to complete their 
education and to get a job to become financially independent. It is 
cost effective for all of us because it saves public money on prenatal, 
maternity, and newborn care, and it has worked to decrease teenage and 
unintended pregnancies.
  In Florida, in 2014 alone, over 160,000 were counseled through 
nonprofit agencies and community health centers, and over 38,000 
unintended pregnancies were prevented, which helped prevent about 
18,000 unintended births. That resulted in hundreds of millions of 
dollars in cost savings. Plus, it is difficult to put a price tag on 
the ability of someone to become self-sufficient and get a good start 
in life.
  Title X is critical for many of my neighbors in Florida, and it 
should be protected. So it is sad to see my Republican colleagues 
target working families and young women to restrict access to 
contraceptives, family planning, and other health services. If 
Republicans are successful, it would only harm our communities, and in 
doing so, you are targeting the folks who need the help the most.
  These politically motivated attacks on women's health are a 
distraction from the real issues. Across the country, women, parents, 
moms, and dads need greater economic and personal security, not less. 
That is what Congress should be focused on.
  I urge my colleagues to vote ``no'' on this harmful resolution.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Alabama (Mrs. Roby), who is my classmate.
  Mrs. ROBY. Madam Speaker, I rise in support of H.J. Res. 43. Congress 
must use its authority to strike this rule and stop the Federal 
Government from forcing States to funnel taxpayer money to abortion 
providers.
  This rule is wrong on process and it is wrong on policy. First of 
all, States have every right to put in place reasonable guidelines for 
how their Federal dollars are spent. For Washington to attempt to 
coerce States in this way would be bad enough, but for unelected 
bureaucrats in the Department of Health and Human Services to go around 
Congress at the eleventh hour of the Obama administration is just 
outrageous.
  Madam Speaker, I think we all agree that low-income women should have 
access to essential title X services, but why is it necessary for those 
services to be funded at the Nation's largest provider of abortion? It 
isn't, of course, but the abortion industry and its supporters want us 
to believe that it is.
  When it comes to funding, they like to pretend that abortion doesn't 
exist and that Planned Parenthood is the only place where women can get 
health care, but that is not true. The truth is that there are more 
than 13,000 federally qualified and rural health centers that offer 
low-cost health care to women. These centers outnumber Planned 
Parenthood clinics 20 to 1; they just don't preform abortions.
  Understanding this, some States have rightly enacted laws and 
policies redirecting title X dollars away from abortion providers and 
toward these noncontroversial clinics. If the true goal here were to 
ensure women's health care, no one should have a problem with that. But 
that wasn't the goal, and everybody knows it.
  There is a reason people call this rule President Obama's parting 
gift to Planned Parenthood. It was a blatant, transparent attempt to 
preserve the pipeline of funding to the Nation's largest abortion 
business. It was wrong, and I urge my colleagues to vote to nullify it 
today.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
California (Ms. Speier).
  Ms. SPEIER. I thank the gentlewoman for her leadership.
  Madam Speaker, it is very hard for me to listen to the conversation 
on the other side of the aisle because it is a conversation they are 
having with themselves, and it is a conversation we are having with 
ourselves.
  Let me be really clear. This is not about Planned Parenthood and 
abortion because we already know that Planned Parenthood gets no 
funding for abortions in this country, pure and simple. Planned 
Parenthood gets funding through title X to provide services for breast 
cancer screenings, cancer screenings, STDs, and contraception.
  What my colleagues on the other side of the aisle are willing to say 
is: We just want to make sure Planned Parenthood doesn't get a dime. 
Just squeeze every dime out of them that may be Federal dollars, even 
though they provide a really important health service.
  So I say to my colleagues on the other side of the aisle, I guess 
what you are saying is, to the 80,000 women last year who were 
diagnosed with cancer because they went to a Planned Parenthood 
facility and of the 800,000 that were screened for cancer, you would 
rather see them die.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentlewoman from 
South Dakota (Mrs. Noem), who is my fellow Ways and Means Committee 
member.
  Mrs. NOEM. Madam Speaker, I rise today in support of H.J. Res. 43 
which overturns an Obama-era regulation forcing States to administer 
title X healthcare funding to abortion providers like Planned 
Parenthood.
  Time and again, this Congress has risen with bipartisan support to 
oppose the taxpayer funding of abortions. Annual provisions, including 
the Hyde amendment, have been passed repeatedly and have saved an 
estimated 2 million innocent lives.
  Today, we rise again to stop the taxpayer funding of abortion 
providers. I

[[Page 2743]]

want to be clear. Nothing we do today will take a penny from women's 
health. Instead, we are empowering States to redirect these funds to 
community health centers and hospitals that offer more comprehensive 
coverage to women.
  In 2014 alone, Planned Parenthood performed more than 300,000 
abortions while failing to provide even the most basic services, like 
prenatal care, at many of their facilities.
  Hospitals and federally qualified health centers not only offer a 
broader range of services, but also greater accessibility in many 
cases. While there is only one Planned Parenthood center in South 
Dakota, we have six federally qualified health centers that operate in 
45 service sites and serve more than 54,000 individuals per year. These 
care centers offer low-income families health services, but they don't 
perform abortions. We can support women's health--and, specifically, 
health care for low-income women--without supporting abortion 
providers.
  Simply put, H.J. Res. 43 does not restrict access or funding to 
health care for low-income women. What it does do is help protect 
taxpayers from funding abortion providers. It empowers the States to 
direct healthcare funding to organizations that truly do support 
women's health, and it makes strides toward protecting the most 
vulnerable among us, the unborn.
  I thank Chairman Black for her commitment to this issue, and I am 
proud to stand beside her as a partner in this effort.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the distinguished 
gentlewoman from the State of Washington (Ms. DelBene).
  Ms. DelBENE. Madam Speaker, another week, another attack on women's 
health. Only 6 days ago, the Senate confirmed a Secretary of Health and 
Human Services who opposes women's access to no-cost birth control--a 
man who claimed that not one woman has struggled to afford 
contraception. Now, House leaders are working to eradicate the number 
of places where women can access birth control. It is unacceptable.
  For more than 40 years, title X has been a bipartisan program that 
helps vulnerable Americans get basic health care like cancer 
screenings, HIV tests, and contraception. In 2014 alone, it prevented 
over 900,000 unintended pregnancies. But if this resolution passes, 
millions will find themselves without access to the essential care that 
they need, especially those in rural and underserved communities.
  I have said it before and I will say it again: Our constituents 
deserve better. It is time to focus on the priorities that matter to 
the American people.
  Madam Speaker, I urge my colleagues to vote ``no.''
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Indiana (Mrs. Walorski), who is a fellow Ways and Means Committee 
member and advocate for children.
  Mrs. WALORSKI. Madam Speaker, I thank Representative Black.
  Madam Speaker, I rise today in strong support of H.J. Res. 43. This 
resolution will overturn an Obama administration rule that forces 
States to direct Federal funds to abortion providers like Planned 
Parenthood.
  States receive Federal funding to support family planning services, 
and they have the discretion to distribute these title X funds in the 
way that best serves their communities. Many States have exercised 
their discretion to direct title X funding to community health centers 
and family health clinics that do not provide abortions and withhold 
funding from abortion providers like Planned Parenthood.
  It is just common sense that States know the needs of their people 
and their communities better than Washington bureaucrats do. The States 
should be able to decide how these Federal funds are distributed.
  Unfortunately, the Obama administration disagreed, so they issued a 
last-minute regulation in their final days in office that would force 
States to distribute funding to abortion providers. Their rule would 
take away States' abilities to direct title X funds to providers that 
offer comprehensive care but do not participate in abortion. It would 
force States to enable the flow of funds to Planned Parenthood and 
others in the abortion industry. I think it is reprehensible.
  Now Congress has the opportunity to right this wrong and undo the 
massive overreach. We are taking action to defend taxpayers and defend 
life by using the Congressional Review Act to overturn this rule. 
Overturning this rule won't reduce funding for women's health care. In 
fact, it will let States direct these funds in the way that is best for 
their citizens. It will ensure States can support women's heath as well 
as protect the unborn.
  Madam Speaker, this resolution is essential to rolling back executive 
overreach and standing up for the sanctity of life. I urge my 
colleagues to join me in supporting H.J. Res. 43.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE. Madam Speaker, I thank the gentlewoman for her 
leadership.
  This is not about States, and it is not about the Federal Government. 
It's about women and the rights of women. H.J. Res. 43 could impact 
nearly 4 million primarily low-income patients that receive family 
planning services at title X sites, annually, across the United States.
  Of those 4 million patients, approximately 69 percent had incomes at 
or below the Federal poverty line, while 61 percent of those patients 
claimed the title X clinic as their only regular source of health care. 
About 60 percent of women who access care from family planning health 
centers consider it their main source; 4 in 10, it is their only source 
of care.
  Approximately 1.5 million Planned Parenthood patients benefit from 
the Nation's family planning program. Approximately 20 percent of these 
patients identify as Hispanic and approximately 50 percent as African 
Americans.
  Every public dollar invested in Planned Parenthood, $7.09 is saved in 
Medicaid-related costs. Planned Parenthood centers are roughly one-
third of the program's clients, although Planned Parenthood health 
centers comprise 10 percent of the publicly supported safety and family 
net.
  This resolution for which we should vote ``no'' is going to take away 
money from people who are in need, who need health care. Where are the 
Republicans on women's rights?
  Madam Speaker, I rise in strong opposition to H.J. Res. 43, a 
congressional resolution rescinding a rule promulgated by the U.S. 
Department of Health and Human Services providing important protections 
to ensure that women, men, and young people can see trusted 
reproductive health care providers, like Planned Parenthood, through 
the Title X family planning program.
  I oppose the disapproval resolution because it is nothing more than a 
blatant attempt to persecute Planned Parenthood and make it easier for 
the state politicians to take away people's health care, specifically, 
the four million people who rely on Title X for birth control and other 
care.
  From birth control, to well-woman exams, to cancer screenings, 
millions of Americans nationwide turn to Planned Parenthood and other 
safety net reproductive health providers as their trusted source of 
health care.
  Many of these Americans, including low-income women, women of color, 
and those living in rural areas, are uninsured and rely on important 
public health programs for affordable health care, including Medicaid 
and the Title X family planning program.
  But their access to health care is under attack across the country 
because in recent years because politicians in at least 14 states have 
taken action to block access to care through Title X, willfully 
ignoring the law, the recommendations of public health experts, and the 
clear and present need in their communities.
  In September 2016, HHS issued a notice of proposed rulemaking (NPRM) 
titled ``Compliance With Title X Requirements by Project Recipients in 
Selecting Subrecipients'' aiming to explicitly bar these types of 
actions.
  HHS opened the proposed regulation to public comment, which closed in 
October 2016 and garnered widespread support, with 91% of the roughly 
145,000 responses in favor of the rule.
  Madam Speaker, Title X provides lifesaving, preventive care to 
millions of people and is cost-effective.

[[Page 2744]]

  Title X helps ensure more than four million persons of low-income 
have health care in this country.
  In fact, Title X is the only way that millions of low-income women or 
uninsured women have access to birth control, cancer screenings, STI 
tests, and other basic care.
  Eighty-five percent of the people served by Planned Parenthood's 
family planning program have incomes below 200 percent of the federal 
poverty level, and 48 percent are uninsured.
  In 2015 alone, Title X provided nearly 800,000 Pap tests, breast 
exams to 1 million women, nearly 5 million tests for STIs, and 1 
million HIV tests.
  About 60 percent of women who access care from a family planning 
health center consider it their main source of health care; for 4 in 
10, it is their only source of care.
  Approximately 1.5 million Planned Parenthood patients benefit from 
the nation's family planning program, 78 percent of whom live with 
incomes of 150 percent of the federal poverty level or less, the 
equivalent of $35,775 a year for a family of four in 2014.
  Approximately 20 percent of these patients identify as Hispanic; and 
approximately 15 percent identify as African American.
  For every public dollar invested in family planning, $7.09 is saved 
in Medicaid-related costs; that is savings to both federal and state 
governments and taxpayers.
  Planned Parenthood health centers serve roughly one-third of the 
program's clients, although Planned Parenthood health centers comprise 
10 percent of publicly supported safety net family planning centers.
  Planned Parenthood health centers are located in the communities 
where access to care is most needed.
  More than half of Planned Parenthood's health centers across the U.S. 
are in rural and underserved communities with limited access to health 
care.
  Seventy-five percent of Planned Parenthood patients have incomes at 
or below 150 percent of the federal poverty level (FPL).
  The idea that other providers could absorb Planned Parenthood's 
patients has been resoundingly dismissed by experts.
  In fact, the American Public Health Association called the idea 
``ludicrous.''
  Planned Parenthood health centers are also considerably more likely 
to offer Title X patients a broader range of contraceptive methods than 
other providers.
  In a study of Community Health Centers (CHCs), among CHCs that 
reported an independent family planning clinic in their largest site's 
community, 69 percent reported referring their patients to providers 
specializing in reproductive health services, like Planned Parenthood 
health centers, for family planning care.
  H.J. Res. 43 is a blatant effort to embolden states to try to block 
women from getting birth control and other preventive care at highly 
qualified family providers.
  By issuing this important protection, the Obama Administration made 
sure that politicians cannot ignore the law and stand in the way of the 
care that women need.
  I urge all Members to vote No on H.J. Res. 43.
  Madam Speaker, I include in the Record a letter and article in 
opposition to this resolution.

                                                February 14, 2017.
     Hon. Mitch McConnell,
     Senate Majority Leader,
     Washington, DC.
     Hon. Charles Schumer,
     Senate Minority Leader,
     Washington, DC.
     Hon. Paul Ryan,
     Speaker, House of Representatives,
     Washington, DC.
     Hon. Nancy Pelosi,
     Minority Leader, House of Representatives,
     Washington, DC.
       Dear Leader McConnell, Speaker Ryan, Leader Schumer and 
     Leader Pelosi: As organizations committed to improving access 
     to health care for all people, the undersigned groups write 
     to strongly oppose H.J. Res. 43 and S.J. Res. 13, legislation 
     to overturn the U.S. Department of Health and Human Services 
     (HHS) final rules updating the regulations governing the 
     Title X family planning program. This critical rule clarifies 
     and reinforces the longstanding requirement that health care 
     providers may not be excluded from the program for reasons 
     unrelated to their qualifications to perform Title X-funded 
     services.
       The Title X family planning program is a vital source of 
     family planning and related preventive care for low-income, 
     uninsured, and young people across the country. Every year, 
     more than 4 million individuals, including LGBTQ people and 
     people living in rural and medically underserved areas, 
     access life-saving care such as birth control, cancer 
     screenings, and testing for sexually transmitted infections 
     (STIs) including HIV at Title X-funded health centers. Title 
     X cannot succeed unless states and other Title X grantees 
     include providers that are optimally qualified to furnish the 
     range of Title X-funded services according to national 
     standards of care. This task becomes all but impossible if 
     experienced, reputable reproductive health care providers are 
     arbitrarily barred from fair consideration.
       An increasing number of states have nevertheless tried to 
     block trusted reproductive health care providers from 
     participating in Title X. To date, at least 14 states have 
     taken official action to target and exclude otherwise 
     eligible providers from the program. Other states have 
     threatened to follow suit. Mounting evidence shows that the 
     exclusion of reproductive health care providers from publicly 
     funded health programs harms health outcomes, widens 
     disparities, and erects new barriers to care. When the very 
     providers that are best suited to deliver Title X-funded 
     services are targeted for exclusion based on factors wholly 
     unrelated to the program's objectives, federal health care 
     resources are poorly and inefficiently distributed and care 
     is less likely to reach individuals in need.
       Ideological exclusions of trusted, highly qualified 
     providers from federally supported health programs undermine 
     health care access and jeopardize the health of the patients 
     these programs serve. Title X patients deserve the 
     opportunity to obtain high-quality family planning care from 
     the providers that are best equipped to provide it. As such, 
     we strongly support HHS's rule reinforcing that grantees must 
     design their provider networks based on the ability to 
     provide care to Title X patients in an effective manner--not 
     based on the political preferences of state lawmakers.
       We strongly urge you to oppose H.J. Res. 43 and S.J. Res. 
     13, legislation that will overturn this important rule and 
     embolden states to attempt to block women from getting birth 
     control and other preventive care at highly qualified family 
     providers.
           Sincerely;
       Advocates for Youth; AIDS Foundation of Chicago; AIDS 
     United; American Association of University Women (AAUW); 
     American Civil Liberties Union; American Medical Student 
     Association; American Society for Reproductive Medicine; 
     Anti-Defamation League; Asian & Pacific Islander American 
     Health Forum; Catholics for Choice; Center for Reproductive 
     Rights; Feminist Majority Foundation; Hadassah, The Women's 
     Zionist Organization of America, Inc.; Human Rights Campaign; 
     Human Rights Watch.
       Ibis Reproductive Health; In Our Own Voice: National Black 
     Women's Reproductive Justice Agenda; Institute for Science 
     and Human Values; The Leadership Conference on Civil and 
     Human Rights; Methodist Federation for Social Action; NARAL 
     Pro-Choice America; National Abortion Federation; National 
     Asian Pacific American Women's Forum; National Center For 
     Lesbian Rights; National Council of Jewish Women; National 
     Family Planning & Reproductive Health Association; National 
     Health Law Program; National Latina Institute for 
     Reproductive Health; National LGBTQ Task Force Action Fund; 
     National Organization for Women; National Partnership for 
     Women & Families.
       National Women's Health Network; National Women's Law 
     Center; People For the American Way; Physicians for 
     Reproductive Health; Planned Parenthood Federation of 
     America; Population Connection Action Fund; Positive Women's 
     Network--USA; Raising Women's Voices for the Health Care We 
     Need; Religious Institute; Sexuality Information and 
     Education Council of the U.S. (SIECUS); The Black Women's 
     Health Imperative; The United Methodist Church, Church and 
     Society; Unitarian Universalist Women's Federation; United 
     Church of Christ, Justice and Witness Ministries; URGE: Unite 
     for Reproductive & Gender Equity; Voices for Progress.
                                  ____


                   [From Mother Jones, Jan. 31, 2017]

  Senate Republicans Take the First Step To Defund Planned Parenthood

                         (By Hannah Levintova)

       Leticia Parra, a mother of five scraping by on income from 
     her husband's sporadic construction jobs, relied on the 
     Planned Parenthood clinic in San Carlos, an impoverished town 
     in South Texas, for breast cancer screenings, free birth 
     control pills and pap smears for cervical cancer.
       But the clinic closed in October, along with more than a 
     dozen others in the state, after financing for women's health 
     was slashed by two-thirds by the Republican-controlled 
     Legislature.
       The cuts, which left many low-income women with 
     inconvenient or costly options, grew out of the effort to 
     eliminate state support for Planned Parenthood. Although the 
     cuts also forced clinics that were not affiliated with the 
     agency to close--and none of them, even the ones run by 
     Planned Parenthood, performed abortions--supporters of the 
     cutbacks said they were motivated by the fight against 
     abortion.
       In December, the Department of Health and Human Services 
     finalized a rule that would prohibit states from withholding 
     federal funds--including Title X family planning money--from 
     Planned Parenthood. On Monday afternoon, a Republican senator 
     introduced a bill that would reverse it, along with a second 
     bill that would prohibit Planned Parenthood from receiving 
     any federal funding--including Medicaid.

[[Page 2745]]

       The bills, from Sen. Joni Ernst (R-Iowa), would redirect 
     federal funds away from Planned Parenthood to other health 
     care providers. The Hyde Amendment already prohibits federal 
     funds from being used for most abortions, but this 
     legislation would bar low-income women who rely on Medicaid 
     and Title X funding for subsidized care from obtaining other 
     women's health care services at Planned Parenthood.
       ``With a pro-life president in the White House and pro-life 
     majorities in the House and Senate, we will continue to work 
     together this year to undo the damage done by the Obama 
     administration,'' wrote Ernst and Rep. Diane Black (R-Tenn.) 
     in an op-ed published in the Washington Examiner on Friday, 
     the day of the annual anti-abortion March for Life.
       The text of one of the bills, S. 241, explains that other 
     entities, including ``state and county health departments, 
     community health centers, [and] hospitals,'' will be able to 
     fill women's health care needs, including contraception, STI 
     testing, and cervical and breast cancer screening. Many 
     health experts say other health providers would not be able 
     to absorb Planned Parenthood's patients. An analysis 
     conducted by the Guttmacher Institute, which publishes 
     research on reproductive health, found that in two-thirds of 
     the counties that have a Planned Parenthood center, these 
     centers serve at least half the women seeking publicly funded 
     contraceptive care. In one-fifth of those counties, Planned 
     Parenthood is the only provider offering subsidized 
     contraceptive care.
       ``If passed, these bills will cause a national health care 
     crisis, leaving millions with nowhere to go for basic care,'' 
     said Dana Singiser, vice president of public policy and 
     government affairs for the Planned Parenthood Federation of 
     America, in a statement.
       Texas offers an example of what women's health care looks 
     like when Planned Parenthood is excluded from public funding. 
     In 2011, the state stopped state funds from going to Planned 
     Parenthood, leading to numerous clinic closures. Other health 
     centers attempted to step in, but Medicaid contraception 
     claims declined by 35 percent, suggesting that fewer low-
     income women were obtaining contraceptive care. There was 
     also an increase in childbirths among women receiving 
     Medicaid who'd previously received contraception from Planned 
     Parenthood clinics.
       A bill to deny federal funds to Planned Parenthood passed 
     both chambers of Congress last year, but was vetoed by then-
     President Barack Obama. Trump is likely to sign Ernst's 
     version of this bill should it cross his desk: Throughout his 
     campaign, Trump promised that defunding the women's health 
     care provider would be a priority for his administration.

  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Weber).
  Mr. WEBER of Texas. Madam Speaker, I rise with my Republican 
colleagues in support of H.J. Res. 43.
  Under the Obama administration's last-minute rule change to title X 
funding, States like Texas are prevented from establishing criteria 
that would eliminate abortion providers from receiving title X grant 
money.
  States have the right and responsibility to choose the health 
providers that best provide and serve the needs of their moms and their 
babies. During my time in the Texas Legislature, we used the 
Alternatives to Abortion program.
  This program provides low-income pregnant women and their babies care 
items during pregnancy, and it also provides preventing information. It 
also funds the counseling referral and pregnancy information hotline 
and the Texas Pregnancy Care Network. Additionally, this program 
supports groups in maternity homes, provides referrals to community and 
social service programs like child care, and offers classes on life 
skills, budgeting, parenting--yes, parenting--stress management, and 
GED preparation.

                              {time}  1415

  Nationally, 13,000 federally qualified health centers and rural 
health centers provide comprehensive healthcare services to low-income 
moms and their babies.
  In my district, the 14th Congressional District, over 30 clinics are 
committed to our community, including moms and their babies. These 
organizations do a terrific job of supporting women, and yes, their 
babies, too.
  We are not cutting funding. We are not cutting care. We are ensuring 
that Federal health centers have the funds and the support they need to 
give the women and the babies the care that they deserve.
  I want to thank the gentlewoman from Tennessee for her efforts to 
stand up for women and their babies.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the distinguished 
gentlewoman from California (Ms. Lee).
  Ms. LEE. Madam Speaker, let me thank Congresswoman DeGette for her 
tireless leadership in fighting for women's health, for healthy 
families in general, and for our children.
  I rise in strong opposition to H.J. Res. 43. It is no surprise that, 
once again, congressional Republicans are trying to undermine women's 
access to health care and basic family planning services.
  This ideological crusade--and that is what it is--will hurt those who 
need help the most, including low-income women, women of color, and 
young women. It would also deny thousands of families from choosing 
their provider of choice--and sometimes the only accessible provider--
under title X.
  Not only is this resolution antiwoman, it is also counterproductive. 
We know that for every dollar spent on title X family planning, we save 
more than $7 on Medicaid-related costs. But my Republican colleagues 
are so determined to take family planning options away from low-income 
women that they are prepared to put ideological perspectives above 
public health.
  As a member of the Labor, Health and Human Services Subcommittee of 
the Appropriations Committee, I, unfortunately, see these attacks on 
women's health all too well. Last year, Republicans tried to completely 
eliminate funding for title X.
  So don't be fooled. This piece of legislation is not about Planned 
Parenthood. It is about Members of Congress trying to control women's 
bodies.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Rothfus).
  Mr. ROTHFUS. Madam Speaker, I thank Representative Black for her work 
on this subject.
  I rise today in strong support of H.J. Res. 43, a joint resolution to 
stop an Obama administration rule that will force States to send 
taxpayer dollars to abortion providers, including abortion giant 
Planned Parenthood.
  In addition to last year's shocking videos where we heard high-
ranking Planned Parenthood officials use jarring language such as doing 
a less crunchy type of procedure to preserve body parts, we have 
recently learned in Pennsylvania that Planned Parenthood was using 
false advertising on its websites.
  The Pennsylvania Family Institute recently found that each Planned 
Parenthood affiliate in Pennsylvania does not provide prenatal 
services, even though all 27 Planned Parenthood locations in 
Pennsylvania had listed ``prenatal'' as a service on their website.
  After these clinics were called and asked, Do you provide prenatal 
services, not one had any such services to offer, but they did offer 
terminations. Planned Parenthood has since removed the word 
``prenatal'' from their booking appointments website.
  They should not be receiving one dime of Federal dollars when they 
are actively attempting to deceive women to get them in the door. 
Abortion is not health care. Subsidizing the destruction of human life 
with Federal dollars in the name of family planning is simply 
unconscionable.
  I urge my colleagues to join me in defending the lives of the unborn 
and support this important joint resolution.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
California (Ms. Judy Chu).
  Ms. JUDY CHU of California. Madam Speaker, I rise today in strong 
opposition to H.J. Res. 43. This bill is another in a long line of 
attacks on women's health, women's choices, and women's lives.
  For 50 years, title X has been the only federally funded program 
dedicated to providing comprehensive family planning services for low-
income patients. Thanks to title X, these women have gained access to 
services like birth control, STD testing, cancer screenings, 
counseling, and sex education.
  For most of its history, title X has received broad, bipartisan 
support from

[[Page 2746]]

Congress. That is because it has helped millions of women and families. 
But now, Republicans are using this longstanding program to continue 
their attack on women's health.
  Last year, Republicans eliminated title X funding from their budget 
altogether. This bill is just the latest attempt to do the same thing 
by putting family planning resources out of reach for poor women across 
the country. We cannot let this happen. We cannot let healthy 
pregnancies and healthy families become a luxury reserved only for the 
wealthy. It must remain a right for all.
  I urge my colleagues to vote against this resolution.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Missouri (Mrs. Hartzler), chair of our Values Action Team.
  Mrs. HARTZLER. Madam Speaker, I rise today to offer my unwavering 
support for the lives of the unborn, to stand in solidarity with the 
States, and to urge my colleagues to support the passage of H.J. Res. 
43.
  This resolution does not cut a dime from family planning funding 
available to States. It simply enables States to direct the funding 
towards nonabortion ``whole women'' healthcare providers, such as rural 
health clinics and federally qualified health centers.
  It is important to remember that, for every Planned Parenthood 
clinic, there are 20 federally qualified health centers. Each year, 
these centers serve over 21 million American women. This is almost 
eight times the impact of Planned Parenthood clinics.
  We know that Federal law requires that federally qualified health 
centers provide mammograms, prenatal services, and emergency medical 
services, none of which are offered by Planned Parenthood clinics.
  The States were wise to prioritize such quality health care for women 
with title X funds. Prior to this new, heavy-handed, agenda-driven 
policy, the States maintained the flexibility to determine grant 
recipients. This last-minute Obama administration rule effectively 
nullifies the policy of 13 States that want to prioritize women's 
health over abortion.
  This Obama-era rule could also impair funding for another 10 States 
that have chosen comprehensive care over abortion-focused clinics like 
Planned Parenthood. But it gets worse. Of the 13 States impacted by 
this rule, five States--Tennessee, Kansas, Oklahoma, Arkansas, and 
Ohio--could lose almost $16 million in title X funding for failing to 
abide by the rule. This regulation forces these States to forego their 
title X funding for all of the women in their State.
  Today's resolution resolves this encroachment on the States, rolls 
back this last-minute rule, and restores flexibility to the States so 
that women can receive the health care they deserve.
  I would like to thank Chairman Black for her work on this resolution, 
and I urge my colleagues to support the passage of H.J. Res. 43.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
New York (Mrs. Carolyn B. Maloney).
  Mrs. CAROLYN B. MALONEY of New York. Madam Speaker, the war on women 
is escalating and more dangerous with H.J. Res. 43.
  Let's not beat around the bush. Let's call this joint resolution what 
it really is. It is a backdoor attempt to restrict access to a woman's 
constitutional right to an abortion.
  We all know that Federal funding for abortion is already prohibited, 
but this goes further--much further. It cuts off funding for 
contraception, screenings, and treatment if a provider also offers 
abortions paid for with private funds.
  Providers either stop doing abortions or they lose the Federal funds 
they need to keep their doors open to serve their communities. In other 
words, the supporters of this resolution are willing to sacrifice 
women's access to basic healthcare services in order to stamp out 
abortion. It is cruel, it is wrong, and I would say it is 
discriminatory. When is the last time this body was called upon to cut 
off access to basic health care for men?
  Vote ``no.''
  Mrs. BLACK. Madam Speaker, I yield 1 minute to the gentleman from 
Florida (Mr. Thomas J. Rooney).
  Mr. THOMAS J. ROONEY of Florida. Madam Speaker, as one of his final 
acts in office, President Obama issued a rule requiring that States 
give title X family planning fund grants to abortion providers like 
Planned Parenthood.
  States have always had the autonomy to distribute these grants to 
providers that they choose. Obama took that freedom away from States by 
requiring them to directly fund abortions under the false assertion 
that this provides women with greater access to health care. That is 
just not true.
  What people seem to forget is that for every 1 Planned Parenthood 
facility in the United States, there are 20 federally funded community 
health centers that stand ready and eager to provide health services to 
women and don't perform abortions.
  States should be able to make their own healthcare decisions. By 
passing this resolution, we return that power to the States.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
Florida (Ms. Frankel), the chair of the Democratic Women's Working 
Group.
  Ms. FRANKEL of Florida. Madam Speaker, for women to thrive in the 
economic and social opportunities of our Nation, we must have the 
ability to control our own reproductive lives with full access to 
healthcare choices.
  Now, here we go again: another Republican bill aimed at taking us 
back to the dark, dangerous days when women were prisoners of their own 
bodies; back to 50 years ago when Katy, a nurse in Florida, had no 
access to legal contraception or abortion. She was a mother of two, 
recently divorced.
  Pregnant and unable to responsibly raise another child, she made an 
appointment on the phone with a nameless person who met her on a lonely 
street corner in Miami. She blindfolded her, hid her under a rug in a 
car, and took her to a garage where she had an abortion.
  But Katy was one of the lucky ones. She survived. Not so fortunate 
were the women who threw themselves down stairs or inserted chemicals 
or coat hangers into their uteruses in order to terminate their 
pregnancy.
  Madam Speaker, we will not go back to those dark, dangerous days.
  Mrs. BLACK. Madam Speaker, I yield 2 minutes to the gentleman from 
Indiana (Mr. Banks), one of our freshman Members.
  Mr. BANKS of Indiana. Madam Speaker, I rise today to voice my strong 
support for H.J. Res 43, which would overturn the previous 
administration's title X family planning funding rule.
  In December, the Obama administration finalized a misguided rule 
which dictates that States must send title X family planning grant 
money to abortion providers. Even more, this rule also threatens to 
deprive noncompliant States, such as Representative Black's home State 
of Tennessee, of all title X family planning funds.
  This politically motivated requirement was made neither in the 
interest of protecting life, nor in the interest of the States.
  Under the rule, States that decline to send title X funds to abortion 
clinics would lose their title X funding completely. If States make the 
decision they want to use their funding to affirm life, then they 
should be allowed to do so. This rule blatantly steps all over states' 
rights and goes out of its way to favor abortion providers at the same 
time.
  Let's ensure States continue to have the freedom and flexibility to 
make the right decisions for themselves. That is exactly what I have 
advocated for my entire career, both in the Statehouse in Indiana and 
again here on the floor of the U.S. House of Representatives.
  I express my strong support for the passage of H.J. Res. 43, 
introduced by Representative Black.

                              {time}  1430

  Ms. DeGETTE. Madam Speaker, may I inquire as to the time remaining on 
each side?

[[Page 2747]]

  The SPEAKER pro tempore. The gentlewoman from Colorado has 15 minutes 
remaining. The gentlewoman from Tennessee has 8 minutes remaining.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
Washington State (Ms. Jayapal).
  Ms. JAYAPAL. Madam Speaker, I rise in strong opposition to this 
resolution. For many people, particularly women, title X funding 
literally means the difference between receiving reproductive health 
care or being forced to go without birth control, critical cancer 
screenings, and other preventive care.
  For the 4 in 10 women who access health care at title X-funded 
providers, cutting this funding would mean cutting their access to 
health care altogether. For people of color, rural communities, and 
those who struggle to make ends meet, cutting title X funds will 
certainly have a disproportionate impact.
  Let's be very clear that these funds are not controversial, but the 
Republican majority in Congress and anti-choice groups are doing their 
best to create a false narrative in order to demonize this funding, 
which has done nothing but improve the lives of millions of people. 
Cutting this funding would actually increase the number of unwanted 
pregnancies by nearly 1 million in just a year alone and would increase 
abortions by 33 percent.
  Women need title X so they can continue to make decisions with their 
doctors. It is 2017, and a woman's uterus is not a political football.
  Mrs. BLACK. Madam Speaker, I must, once again, talk about what this 
resolution really does. This resolution empowers States. It empowers 
States that are able to choose to invest in women's health care over 
abortion by sending those title X dollars to clinics that do not 
destroy innocent life. My colleagues on the other side talked about how 
this is destructive to women's health. I want to just mention that the 
true destruction to women's health is abortion. That is the little girl 
who is aborted that will never know about being a woman.
  This bill does nothing to prohibit States from deciding where to best 
use their dollars, but in States such as mine in Tennessee for the last 
6 years, who have made that decision to send their dollars to 
facilities that they believe give the best women's health care, 
comprehensive health care, to over 75,000 women in our State, more than 
many States that surround us that have larger populations.
  If this were prohibiting women from getting services, we wouldn't be 
so successful with providing services to more than 75,000 women in our 
State. We haven't seen a decrease in services. We have seen an increase 
in services. If you were to ask these women what they thought about 
services that they are getting in these other facilities such as 
Department of Health and federally qualified health centers, you would 
see they are very satisfied because they get comprehensive services 
that go beyond what places like Planned Parenthood can even provide for 
them. They do mammograms, they do procedures if there are cancer cells 
found in a woman's cervix.
  So this whole ruse that this is a war on women and that we are taking 
away women's right to healthcare services is a ruse. All this does is 
to say, if a State like Tennessee decides this is the best place to 
give the best quality of care for a woman, and hopefully their babies 
and their children--which, if you go to these clinics, you will see 
them all running around, they have life--it just gives them the choice 
to do that.
  Don't take away that choice from my State. Don't punish my State 
because we do what we believe is the best thing for women's health.
  Madam Speaker, I reserve the balance of my time.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentleman from 
California (Mr. Bera).
  Mr. BERA. Madam Speaker, I thank my colleague for her leadership on 
this subject.
  I am a doctor, and I have worked in low-income and free clinics, and 
I know title X funding works. It has impact. Here is how we also know 
it works: by expanding access to full reproductive services under the 
Affordable Care Act and contraception, we have seen a dramatic 
reduction in the number of unintended pregnancies.
  We are debating the wrong thing here. We should be increasing title X 
funds right now. We should be debating how we make access to full 
reproductive services more readily available. That is what the women of 
America want.
  I urge my colleagues to vote ``no'' on this dangerous bill. I urge my 
colleagues to understand the women of America are watching.
  I also urge, if somehow this makes it to the President's desk: The 
mothers and daughters, Mr. President, are watching; so be careful here. 
This is about preserving access to care and full reproductive rights. 
We are watching.
  The SPEAKER pro tempore. Members are reminded to direct their remarks 
to the Chair.
  Mrs. BLACK. Madam Speaker, I reserve the balance of my time.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
Maine (Ms. Pingree).
  Ms. PINGREE. Madam Speaker, title X family planning services are an 
essential lifeline for Mainers who need access to high-quality 
preventive and reproductive care, from cancer screenings to STI 
testings, to birth control. The resolution we are debating today 
threatens access to these critical services.
  Every year, Maine's network of title X providers serves more than 
22,000 individuals in nearly every county, including some of the most 
rural and underserved communities in our State. Sixty-five percent of 
last year's patients had outcomes that qualified them for free or 
reduced-cost services.
  Family planning health centers often end up being their patients' 
primary source of health care. Providers are trusted members of the 
community. The care they deliver is high quality, and often they are 
the only affordable local option. Without title X funds, thousands of 
women and men throughout Maine would struggle to access and afford 
alternative primary care.
  At a time when Republicans want to repeal the Affordable Care Act 
without a replacement plan, it is more important than ever to preserve 
title X as a cornerstone of our safety-net healthcare system.
  Mrs. BLACK. Madam Speaker, I reserve the balance of my time.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentleman from 
Michigan (Mr. Kildee).
  Mr. KILDEE. Madam Speaker, I thank my friend for her incredible 
leadership on this issue.
  Rather than working across the aisle with Democrats to grow our 
economy, to rebuild older communities, to create new jobs, Republicans 
are, again, focused on attacking women's health, undermining healthcare 
programs that provide preventive care for over 4 million Americans, 
many low-income women who would otherwise be uninsured.
  Eliminating this rule makes it harder for women and families to have 
access to lifesaving cancer screenings, for example, birth control, and 
other vital health services. These funds are providing necessary health 
services, Madam Speaker, and everyone in this debate knows what this is 
about. These dollars do not support abortion. We know Federal law 
prohibits these dollars from being used for that purpose, but to hear 
our friends on the other side, they would imply that is the case.
  Now, there is and should be a legitimate debate on that subject, but 
it has been the law and it continues to be the law that these dollars 
are not used for abortion services. This is about health care. This is 
about lifesaving health care for women, and it ought to be preserved.
  Mrs. BLACK. Madam Speaker, I reserve the balance of my time.
  Ms. DeGETTE. Madam Speaker, I yield 1 minute to the gentlewoman from 
Michigan (Mrs. Lawrence).
  Mrs. LAWRENCE. Madam Speaker, I rise today in strong opposition to 
H.J. Res. 43, yet another partisan attack against women's health care.
  For more than four decades, title X has helped some of the most 
underserved women in our country get access to family planning services 
that

[[Page 2748]]

otherwise would not have been received.
  Once again, some of my colleagues believe that they have the right to 
impose their beliefs on a nonpartisan issue. Instead of allowing women 
to choose family planning services that are right for them, this 
Chamber is voting to take that choice away. Instead of attacking 
legitimate title X qualified providers who serve women across our 
country, our Chamber should be working to ensure that all Americans 
have the right to quality health care.
  Madam Speaker, I urge my colleagues to stop this attack on women's 
health care. I urge my colleagues to defeat this resolution.
  Ms. DeGETTE. Madam Speaker, it is my understanding that the other 
side is reserving its time to close. Is that correct?
  Mrs. BLACK. That is correct.
  Ms. DeGETTE. I yield 1 minute to the gentlewoman from Massachusetts 
(Ms. Clark).
  Ms. CLARK of Massachusetts. Madam Speaker, I thank the gentlewoman 
from Colorado for all her leadership.
  We are barely 6 weeks into this new Congress and the Republicans are 
back at it again, attacking comprehensive health care for American 
women. The regulation under attack says that in order to be awarded 
title X funding, you must be able to deliver the services. Those 
services are family planning and related preventative health services.
  The majority is correct, we are not talking about abortion because 
abortion is not funded by title X.
  Why would Republicans oppose this regulation?
  Because it allows them a backdoor way to make funding decisions based 
on ideology, not quality of care.
  Don't we want the best health outcomes for the over 4 million 
patients who benefited last year from HIV tests, breast exams, and 
contraception coverage under title X?
  Title X-funded healthcare providers around this country are high-
quality professionals who provide needed care for millions of families, 
many of whom are underserved. I oppose this resolution.
  Ms. DeGETTE. Madam Speaker, I yield 2 minutes to the gentleman from 
New York (Mr. Engel), a member of the Committee on Energy and Commerce.
  Mr. ENGEL. Madam Speaker, this is not a women's issue or a men's 
issue. It is an issue for what is right. People have a right to make 
health choices. If someone doesn't believe in abortion, then make that 
choice for yourself. If someone believes in something else, then they 
have the right to make that choice. So eligibility for title X funding 
should be based on a provider's ability to provide family planning 
services, period. Whether a provider offers safe and legal abortions 
with private funds should not be used to prevent women and men from 
getting preventive care like cancer screenings or HIV tests. That is 
all the rule requires.
  It should not be controversial. Yet, here we are.
  What effect would this Congressional Review Act have?
  Well, Kansas has given us an ominous preview. When Kansas defunded 
providers that offered abortion services, the number of Kansans 
accessing cancer screenings, STI tests, and other care through the 
title X program plummeted by thousands. A vote for this CRA is a vote 
to multiply that number.
  The Americans who will be affected by this CRA will lose the 
opportunity to see the provider of their choice, sometimes the only 
viable provider.
  Why would we want to put women--why would we want to put anybody in 
that category, where they cannot see the only viable provider because 
someone else doesn't like what the doctor can do?
  I urge my colleagues to vote ``no.'' My Republican friends always 
talk about individual freedom and how important it is. This is an 
individual freedom of a woman's right to control her own body and to 
make personal choices on health care. We should not interfere with 
that. We should allow the most and the best health care to be available 
to all people. I urge a ``no'' vote.
  Ms. DeGETTE. Madam Speaker, I yield 2 minutes to the gentleman from 
New York (Mr. Nadler).
  Mr. NADLER. Madam Speaker, Republicans are continuing their crusade 
to cut off access to comprehensive family planning services. Last year 
they tried to zero out title X in their budget. This year they intend 
to repeal ACA's cost-free contraception coverage for women with private 
insurance. Today Republicans are attempting to stop the flow of title X 
grants to health centers around the country.
  Title X grants ensure that low-income families have access to birth 
control and can plan their pregnancies so that moms and kids stay 
healthy. Research has shown that without these vital services, the 
unintended pregnancy rate would be 33 percent higher and the number of 
abortions would also be higher. My anti-choice Republican colleagues 
should cheer this program, but instead not only are Republicans trying 
to defund Planned Parenthood so they won't be able to provide 
contraception help, but now we are hypocritically rolling back a rule 
that allows title X funds to flow to reproductive health centers, which 
are the most effective providers of title X services and which we were 
told would provide the contraception and other health services that 
Planned Parenthood no longer would be able to.

                              {time}  1445

  Women are watching us today. They know that this joint resolution is 
nothing more than another attempt to stop low-income women from 
accessing the health care they need and to allow the government to once 
again step between women and their doctors.
  It is no secret I support a woman's constitutional right to access 
abortion; but even if you don't and are committed to reducing abortion 
in this country, you should step up to the plate and support 
comprehensive and robust family planning for all women. This joint 
resolution should do the opposite. We should all support contraception 
for the women of this country.
  I urge my colleagues to reject this joint resolution.
  Ms. BLACK. Madam Speaker, I continue to reserve the balance of my 
time.
  Ms. DeGETTE. Madam Speaker, I yield 2 minutes to the gentlewoman from 
Illinois (Ms. Schakowsky).
  Ms. SCHAKOWSKY. Madam Speaker, well, here we are again, considering 
legislation that would harm women and families.
  Let's be clear: House Republicans do not support family planning 
title X. For years, Republicans have tried to completely eliminate 
funding for title X through the appropriations process. So think about 
that. We are debating contraception in 2017--astonishing.
  Title X provides millions of low- and middle-income men and women 
with access to reproductive healthcare services. The joint resolution 
we are voting on today would allow States to discriminate against title 
X providers who perform abortion with non-Federal funds by removing 
them from the program, leaving patients with few options for the care 
they need.
  Again, let's be clear. If you want to reduce the number of abortions, 
you need to ensure everyone has access to family planning. Teen 
pregnancy and the rate of abortion are at historic lows because we have 
worked to make contraception more affordable and accessible.
  For over 60 percent of title X patients, the clinics they visit for 
family planning services are their only regular source of care, and yet 
we are considering legislation that would result in clinic closures and 
would prevent men and women from seeing trusted providers in their own 
communities.
  Do Republicans oppose cancer screening for cervical breast cancer? Do 
they oppose STI testing? Do they oppose contraception? The answer seems 
to be yes because Republicans continue to ignore these facts in their 
effort to harm women's health.
  I urge my colleagues to put an end to the war on women and to oppose 
this very dangerous legislation.
  Ms. BLACK. Madam Speaker, I continue to reserve the balance of my 
time.

[[Page 2749]]


  Ms. DeGETTE. Madam Speaker, I yield myself the balance of my time to 
close.
  Madam Speaker, we hear today this really isn't about denying women 
and families access to family planning and birth control because States 
would just simply take that title X money and put it somewhere else. 
Unfortunately, this seems to be a bit of magical thinking. Even the 
Congressional Budget Office said that as many as 390,000 women would 
lose access to care and 650,000 women would have reduced access if 
legislation like this passed.
  The fact of the matter is you can't simply shift all of these people 
from title X family planning centers like Planned Parenthood to 
community health centers, as the other side asserts. For one thing, 69 
percent of the community health centers actually refer patients to 
family planning providers like Planned Parenthood, and only 19 percent 
of community health centers report that their largest sites both 
prescribe and dispense all types of contraceptive methods. Only half of 
community health centers that received title X funding provide IUDs and 
other types of long-acting birth control, the most effective type of 
birth control, so you can't just shift everybody else someplace else.
  In fact, the National Association of Community Health Centers itself 
said that they could not treat all of the patients that Planned 
Parenthood now has if this legislation went through. Let's just call 
this joint resolution what it is. It is an attempt to take away 
important family planning resources from the women and families of 
America.
  Now, I think if we all support title X when the annual appropriations 
bill comes up this year, I would ask my colleagues on the other side of 
the aisle to please join me and my colleagues in an effort to increase 
title X funding. In all the years I have been in Congress, I have seen 
attempt after attempt not only to reduce abortion availability, but 
also to stop family planning services. I think that is something we 
could agree with on, and I think we could do that.
  So in the meantime, let's make sure that the women of America can get 
access to the family planning they need, and let's continue to give 
family planning money to all of these interests to do that.
  Again, I would like to reiterate, we have no family funding for 
abortions. That is the law. I don't like the law, but that is the law. 
We are talking about family planning and title X. That needs to be 
preserved and enhanced. Vote ``no'' on this joint resolution.
  I yield back the balance of my time.
  Mrs. BLACK. Madam Speaker, I yield myself the balance of my time.
  I include in the Record letters from March for Life Action, Christian 
Medical and Dental Associations, and United States Conference of 
Catholic Bishops.

                                        March for Life Action,

                                Washington, DC, February 15, 2017.
     Representative,
     House of Representatives, Washington, DC.
       Dear Representative: On behalf of March for Life Action and 
     the hundreds of thousands of our supporters and fellow 
     marchers, I urge you to vote in favor of H.J. Res. 43, 
     sponsored by Rep. Diane Black (R-TN). When H.J. Res. 43 comes 
     to the House floor for a vote we will be scoring the vote in 
     our annual scorecard for the First Session of the 115th 
     Congress.
       In the waning days of his Administration President Barack 
     Obama, using his power at Health and Human Services, issued a 
     rule that locked down federal grants for abortion-giant 
     Planned Parenthood but also usurped state's rights by 
     blocking states seeking to defund the abortion industry and 
     redirect funds to county health departments, community health 
     centers and other clinics that put women's health above an 
     abortion agenda.
       H.J. Res. 43 does not reduce funds for family planning, but 
     allows states to assure that taxpayer funds do not support or 
     underwrite abortion providers when so many Americans have 
     ethical reservations about this procedure. The time has come 
     for a clean break between government support of family 
     planning activities and abortion.
       Again, on behalf of March for Life Action, I strongly 
     encourage your vote for H.J. Res. 43. March for Life Action 
     will score this vote in our annual scorecard.
           Sincerely,
                                                  Thomas McClusky,
     Vice President of Government Affairs.
                                  ____

                                               Christian Medical &


                                          Dental Associations,

                                    Bristol, TN, January 16, 2017.
     Hon. Paul Ryan,
     Speaker, House of Representatives, Washington, DC.
     Hon. Mitch McConnell,
     Majority Leader, U.S. Senate, Washington, DC.
       Dear Speaker Ryan and Majority Leader McConnell: Thank you 
     for your strong, principled and common-sense leadership on 
     the issue of preventing American tax dollars from funding 
     abortion on demand. Thank you also for your commitment to 
     providing healthcare access to the poor and other vulnerable 
     patients in need.
       On behalf of the over 18,000 members of the Christian 
     Medical Association, we urge you to:
       1. ensure the reallocation of funding currently used by 
     abortion-performing, partisan political organizations such as 
     Planned Parenthood, by directing that funding instead to the 
     over 13,000 Federally Qualified Health Centers (FQHCs) and 
     Rural Health Centers (RHCs); and,
       2. overturn, through the Congressional Review Act, the US 
     Department of Health and Human Services (HHS) rule finalized 
     December 19, 2016, titled ``Compliance with Title X 
     Requirements by Project Recipients in Selecting 
     Subrecipients,'' in order to ensure that states are allowed 
     to take a similar direction in allocating federal funding.
       Many of our members serve in federally funded centers that 
     focus on providing care to patients regardless of who the 
     patient is or what the patient's values, orientation, 
     ethnicity or any other qualities may be. As you know well, 
     needy patients depend on these centers and on physicians like 
     our members to provide healthcare when likely no one else 
     would provide healthcare for them. FQHCs provide 
     comprehensive services and a ``medical home'' for whole 
     families and work in the areas of most critical need.
       According to the independent government watchdog GAO in 
     2012, FQHCs served 21 million individuals and provided 
     services including STD testing, cancer screening and 
     contraceptive management, as well as other services including 
     immunizations and general child wellness exams. FQHCs and 
     RHCs often meet patient needs on modest budgets, and those 
     who serve in these centers often do so at great personal 
     financial sacrifice. Unlike Planned Parenthood, which follows 
     an aggressive business plan designed to maximize profits on 
     services such as abortion, these centers exist for the 
     purpose of serving the nation's most needy patients.
       Yet some medical groups like the American Congress of 
     Obstetricians and Gynecologists, whose pro-abortion ideology 
     aligns with Planned Parenthood and whose members profit 
     personally from working with Planned Parenthood, decry 
     ``political interference in the patient-physician 
     relationship.'' This cry comes, oddly enough, while applying 
     pressure on politicians to fund political groups like Planned 
     Parenthood. It is also worth observing what sources such as 
     the nonpartisan Center for Responsive Politics and PolitiFact 
     National have confirmed--that Planned Parenthood spends 
     millions of dollars each year for one partisan purpose: to 
     elect Democrats and defeat Republicans.
       It's hard to get more political than that, and it's 
     impossible to get more politically partisan than that.
       The majority of Americans do not want their tax dollars to 
     subsidize abortion, and they certainly do not want their tax 
     dollars to subsidize an abortion-performing partisan 
     political machine. Because of the strong concern of American 
     taxpayers, existing federal law addresses direct funding of 
     abortion. However, the fungible nature of federal grants to 
     Planned Parenthood means that every American's tax dollars, 
     regardless of their convictions about abortion, are being 
     used to prop up the abortion industry.
       Any organization that wishes to avoid political 
     entanglement can do so quite easily--by simply foregoing 
     government funding. Those who seek funding should expect 
     federal and/or state oversight, requirements and standards.
       Even the most modest of standards should disqualify from 
     federal funding organizations such as Planned Parenthood, 
     given the recent findings of the Select Investigative Panel 
     on Infant Lives, the list of 15 criminal and regulatory 
     referrals made by the Panel, and the referral by the Senate 
     Committee on the Judiciary to the FBI and the Department of 
     Justice for investigation and potential prosecution.
       If any organization can and should do without federal 
     funding, the billion-dollar, corrupt abortion business 
     Planned Parenthood is a prime example.
       We respectfully urge you to reallocate American tax dollars 
     away from such profit-centered, divisive and partisan 
     organizations and provide funding instead to patient-
     centered, non-controversial and nonpartisan Federally 
     Qualified Health Centers (FQHCs) and Rural Health Centers 
     (RHCs). And we urge you to ensure that states can do the 
     same, applying reasonable state standards and requirements to 
     those who seek to use taxpayer funds. Thank you very much for

[[Page 2750]]

     your consideration of these views, and for your leadership on 
     this issue.
           Sincerely,
     David Stevens, MD, MA (Ethics) CEO.
                                  ____

         United States Conference of Catholic Bishops, Secretariat 
           of Pro-Life Activities,
                                Washington, DC, February 14, 2017.
       Dear Representative: I write on behalf of the U.S. 
     Conference of Catholic Bishops' Committee on Pro-Life 
     Activities to urge your support for H.J. Res 43. This 
     resolution of disapproval would nullify former President 
     Obama's final rule relating to compliance with Title X 
     requirements by project recipients. 81 Fed. Reg. 91852 (Dec. 
     19, 2016). The stated purpose of this rule change is to 
     prevent states from excluding providers such as Planned 
     Parenthood from sub-awards based on state criteria, such as a 
     requirement that sub-recipients provide comprehensive primary 
     and preventive care in addition to family planning services.
       The Title X rule change is bad public policy and should be 
     nullified for several reasons. First, it is deeply troubling 
     to many Americans that Planned Parenthood, the nation's 
     largest abortion network (performing over a third of all 
     abortions), receives more than half a billion taxpayer 
     dollars per year. This concern has rightly grown with 
     revelations about Planned Parenthood's willingness to traffic 
     in fetal tissue from abortions, and to alter abortion methods 
     not for any reason related to women's health but to obtain 
     more ``intact'' organs. Additionally, a recent revelation 
     that the vast majority of Planned Parenthood facilities do 
     not provide prenatal services provides additional evidence of 
     its bias toward providing and promoting abortion.
       Second, the Department of Health and Human Service's stated 
     objective in preventing states from ensuring the seamless 
     delivery of comprehensive care places the Department in a 
     self-contradictory position. Last year in the Nation's 
     highest court, HHS touted the seamless coverage of health 
     services as a virtue. Indeed, the Department argued that 
     seamlessness is a government interest of the highest order, 
     sufficient to outweigh constitutionally and statutorily 
     protected religious objections.
       In this new rule, however, HHS takes the opposite position, 
     saying that the seamless provision of services is an ill to 
     be avoided. The present rule would ensure that the provision 
     of care is fragmented, rather than seamless, because it would 
     undermine state requirements that sub-recipients provide 
     primary and preventive care in addition to family planning. 
     Seamlessness cannot at one and the same time be a government 
     interest of the highest order when it disadvantages religious 
     organizations, but an affirmative ill to be avoided when it 
     disadvantages Planned Parenthood.
       Third, states may have other reasonable and persuasive 
     grounds for disqualifying entities from sub-awards that go 
     beyond the ability of such entities to ``provide Title X 
     services'' as the rule states (81 Fed. Reg. at 91860). For 
     example, a sub-award applicant may have been involved in 
     fraudulent practices, or the applicant or its stakeholders 
     may even have committed a crime, bearing on the applicant's 
     fitness and suitability for a sub-award. Indeed, the 
     requirements for federal awards and sub-awards in general are 
     typically accompanied by all sorts of standards, many of 
     which are imposed by the federal government itself, and those 
     standards often have little or nothing to do with the ability 
     to provide services (governmental guidelines are replete with 
     such requirements). States may also have widely differing 
     standards for sub-awardees based on the states' own policy 
     judgment. Therefore, it should be permissible for states to 
     decline to make a sub-award when the sub-awardee does not 
     meet applicable criteria, whether federal or state, even if 
     the entity is, strictly speaking, able to ``provide Title X 
     services.'' Those criteria, of course, themselves remain 
     subject to applicable federal and state law.
       For each of these reasons, we urge you to support H.J. Res. 
     43.
           Sincerely,
     Timothy Cardinal Dolan,
       Chairman, Committee on Pro-Life Activities, United States 
     Conference of Catholic Bishops.

  Mrs. BLACK. Madam Speaker, the 10th Amendment of the Constitution 
reads pretty clearly to me: ``The powers not delegated to the United 
States by the Constitution, nor prohibited by it to the States, are 
reserved to the States respectively, or to the people.''
  I understand that there is a diversity of views represented in this 
Chamber on matters of health care and human life. I am not asking my 
colleagues to set those views aside with this vote. I am simply asking 
them not to substitute their judgment for the will of the States.
  With this resolution, we are letting States care for their citizens 
the best way they know, just as they have had that ability for the past 
45 years, and we are maintaining access to care for women and families.
  I urge a ``yes'' vote on this resolution.
  I yield back the balance of my time.
  Ms. ESHOO. Madam Speaker, I rise today in opposition to H.J. Res. 43 
which is another baseless and dangerous attack on women's health care 
providers.
  The title X Family Planning Rule, passed almost 50 years ago, already 
requires states to base title X funding on a provider's ability to 
provide title X services. This rule protects title X providers from 
facing unwarranted discrimination and allows them to continue doing the 
important work 4 million Americans rely on every year. Title X services 
include family planning services, cancer screenings, birth control, STI 
testing and basic care. To diminish these services will result in 
women, men and young people with the greatest need being denied the 
opportunity to have any health care.
  Whether or not a provider provides safe and legal abortions with 
private funds is irrelevant to their ability and capacity to provide 
title X services. In fact, it is preventive services and family 
planning offered through title X programs that help to lower the number 
of unintended pregnancies. But attacks on these providers and the 
services they offer in their communities persist.
  This resolution rolls back protections that should already be 
guaranteed, but repeated attacks on family planning providers have 
resulted in the need for rules like the one this resolution dismantles. 
That is why I strenuously oppose this resolution. It should be rejected 
as an unjustified and unnecessary attack on title X programs and the 
services they provide for millions of low income Americans.
  Mrs. DAVIS of California. Madam Speaker, it's been less than two 
months since the start of the 115th Congress and Republicans have 
already taken every opportunity to roll back progress made for women.
  They have pledged to tear down the Affordable Care Act and block 
access to Planned Parenthood.
  They passed a bill through the House that limits insurance coverage 
for comprehensive reproductive healthcare.
  Now they've turned their sights to title X, a family planning program 
that is crucial for women's health.
  There are serious consequences for scaling back title X: without the 
contraceptive services provided at these title X sites, pregnancy rates 
would be 30 percent higher among teens.
  We in government should be making it easier for young people to make 
smart and informed decisions, not depriving them of the ability to be 
responsible about their health.
  Please, Madam Speaker, think about those young women. Their lives and 
their health should be a concern to all of us.
  Mrs. BLACK. Madam Speaker, I include in the Record 3 letters, one 
from myself and Senator Joni Ernst, a letter from the Family Research 
Council, and one from 25 outside organizations, which support H.J. Res. 
43.

                                Congress of the United States,

                               Washington, DC, September 23, 2016.
     Hon. Sylvia Mathews Burwell,
     Secretary, U.S. Department of Health and Human Services, 
         Washington, DC.
       Dear Secretary Burwell: We write to express our strong 
     opposition to the Department of Health and Human Services 
     (HHS) September 7, 2016, notice of proposed rulemaking titled 
     ``Compliance with Title X Requirements by Project Recipients 
     in Selecting Subrecipients.'' Although we appreciate the 
     Department's intent to follow proper regulatory procedure 
     pursuant to the Administrative Procedure Act, HHS's purpose 
     for engaging in the rulemaking appears on its face to be an 
     attempt to subvert the will of elected representatives.
       Moreover, apart from the Department's impetus for the 
     notice of proposed rulemaking, we also question whether the 
     Department's stated rationale adequately supports its 
     conclusion that providers with a reproductive health focus 
     are more ``effective'' than other health providers that offer 
     comprehensive care for women and men. Nowhere in the proposed 
     notice of rulemaking does HHS clearly define what it means to 
     provide Title X services in an ``effective'' manner. It does 
     appear to assert that a number of factors--such as the range 
     of contraceptive methods on-site, the number of clients in 
     need of publicly funded family planning services served, and 
     the availability of preconception care--distinguish providers 
     with a reproductive health focus as more ``effective'' and 
     ``high quality'' than other types of providers. However, that 
     list of factors falls far short of all of the attributes and 
     recommendations included in the Centers for Disease Control 
     and Office of Population Affairs report entitled ``Providing 
     Quality Family Planning Services: Recommendations of CDC and 
     the U.S. Office of Population Affairs.''
       To further complicate the argument about quality and 
     effectiveness, the data cited in

[[Page 2751]]

     the notice of proposed rulemaking is not adequate for 
     determining patient outcomes. The Department relies heavily 
     on utilization and demographic statistics, but appears to 
     lack hard data regarding actual patient outcomes and need, as 
     the Department does not require grantees to track patients or 
     verify their income. As you know, the issue of inadequate 
     data has previously been raised by the Institute of Medicine 
     (IOM), after the HHS Office of Family Planning in 2007 asked 
     IOM to provide a critical review of the Title X Family 
     Planning Program. In addition to finding ``no clear, 
     evidence-based process for establishing or revising program 
     priorities and guidelines,'' IOM stated the following in its 
     May 2009 Report Brief:
       ``The committee concludes that the program does not collect 
     all the data needed to monitor and evaluate its impact. 
     Therefore, the committee proposes a comprehensive framework 
     to evaluate the program and assess how well clinics meet the 
     family planning needs of the program's clients. The committee 
     concludes that additional data will be needed in the areas of 
     client needs, structure, process, and outcomes in order to 
     assess the program's overall progress.''
       We welcome evidence that this recommendation has been fully 
     adopted, but are unaware of any clear evidence confirming 
     that to be the case. If HHS cannot clearly define an 
     ``effective'' or ``high quality'' provider, it is unclear to 
     us how state and local project grantees are supposed to do so 
     in order to comply with this proposed rule. It is also 
     therefore unclear how HHS will be able to accurately 
     determine in every case whether state or local project 
     recipients--who are generally closer to and more familiar 
     with subrecipients and the patient base in their geographical 
     region--have considered inappropriate criteria in evaluating 
     subrecipients. Rarely do the American people benefit when the 
     federal government attempts to substitute its judgment for 
     that of state or local governments--particularly when the 
     criteria used to inform that judgment are unclear, and that 
     judgment is not supported by coherent and impartial facts.
       Finally, if HHS is going to assert the authority to adapt 
     its rules in order to address changing circumstances, we 
     implore HHS to consider the recent general shift in health 
     care policy toward comprehensive care. As HHS states on its 
     website, in addition to assisting individuals and couples in 
     planning and spacing births, part of the mission of Title X 
     is to contribute to ``improved health for women and 
     infants.'' HHS's suggestion that subrecipients like federally 
     qualified health centers--which provide greater preventive 
     and primary health care services than providers with a 
     reproductive health focus--are per se less ``effective'' than 
     providers with a reproductive health focus does not comport 
     with that stated mission.
       We urge HHS to reconsider this overreaching and ill-
     supported rule. We will continue to closely monitor this 
     proposed rulemaking, and intend to submit this letter as a 
     formal comment. We look forward to a detailed response from 
     your Department.
           Sincerely,
     Joni K. Ernst,
       United States Senator.
     Diane Black,
       United States Congressman.
                                  ____
                                  
         


                                      Family Research Council,

                                Washington, DC, February 14, 2017.
     House of Representatives,
     Washington, DC.
       Dear Representative: On behalf of Family Research Council 
     and the families we represent, I urge you to vote Yes on Rep. 
     Diane Black's (R-TN) H.J. Res. 43, a joint resolution of 
     disapproval under the Congressional Review Act to overturn 
     former President Obama's HHS final rule on Title X family 
     planning funds (81 FR 91852, December 19, 2016). This rule 
     blocks states from restricting Title X family planning funds 
     to abortion providers like Planned Parenthood, effectively 
     creating a backdoor handout for the abortion industry. 
     Congress can and must act to overturn this harmful rule, 
     which lacks any statutory basis. FRC will score in favor of 
     this resolution.
       This rule prohibits Title X primary grant recipients, 
     including states and some private entities, from 
     ``prohibit[ing] an entity from participating for reasons 
     other than its ability to provide Title X services.'' The 
     stated intent of this rule is to coerce numerous states to 
     give family planning funds to abortion providers like Planned 
     Parenthood. This harms states which have chosen to prioritize 
     these family planning funds to health clinics and community 
     health centers that seamlessly offer a full range of 
     healthcare services, including family planning, but which do 
     not participate in abortion. In addition, the rule disrupts 
     the current health care arrangements of tens of thousands of 
     women who obtain services that are uniquely provided to them 
     by current Title X-funded comprehensive health care clinics 
     in those states.
       The Title X statute of the Public Health Service Act itself 
     requires that no funds may be used for ``programs where 
     abortion is a method of family planning,'' but nowhere does 
     the law say that states cannot exclude certain providers, let 
     alone abortion providers. Furthermore, states realize that 
     money is fungible. When Planned Parenthood or other abortion 
     providers receive Title X grant funding, it frees up 
     resources for them to spend more on abortion, their main 
     source of non-governmental income.
       States should be free to allocate Title X funds in a way 
     that clearly keeps family planning and abortion separate by 
     not funding abortion providers like Planned Parenthood, which 
     use abortion, the killing of an innocent unborn human being, 
     as a form of ``family planning.'' Obama's HHS rule on Title X 
     is an executive overreach and a handout to the abortion 
     industry that is simply without basis in the law.
       Again, on behalf of FRC, I urge you to vote for Rep. Diane 
     Black's H.J. Res. 43, a Congressional resolution of 
     disapproval to overturn this harmful rule. FRC will score in 
     favor of this resolution.
           Sincerely,
                                                David Christensen,
     Vice President for Government Affairs.
                                  ____

                                                February 15, 2017.
       Dear Member of Congress: On behalf of the millions of 
     members of our national and state-based pro-life and pro-
     family organizations listed below, we urge you support 
     application of the Congressional Review Act to eliminate 
     former President Obama's 11th-hour rule preventing states 
     from eliminating Title X funding from Planned Parenthood and 
     other abortion providers.
       During the 114th Congress, efforts to defund America's 
     abortion giant were spurred by undercover videos which show 
     that Planned Parenthood has been engaged in unethical and 
     possibly illegal practices connected to the trafficking of 
     unborn children's organs for profit. The videos detail 
     Planned Parenthood's willingness to manipulate abortion 
     methods--at times, in ways that raise questions about whether 
     the ban on partial-birth abortion has been violated--to more 
     easily obtain intact hearts, lungs, brains, and other organs 
     to be sold to tissue brokers.
       Because of Congressional efforts to defund Planned 
     Parenthood and President Donald Trump's campaign commitment 
     to defend the nation's largest abortion provider, President 
     Obama finalized an 11th-hour rule forcing states to award 
     Title X funds to Planned Parenthood and other abortion 
     providers.
       Like other efforts to defund Planned Parenthood, the 
     Congressional Review Act eliminating President Obama's 11th-
     hour rule would allow states to continue using their legal 
     authority to award Title X funds to family planning clinics 
     that do not engage in abortion or trafficking of baby body 
     parts.
       We urge the 115th Congress to act swiftly to undo the 
     bureaucratic protectionism that President Obama put in place 
     to grant America's largest abortion provider permanent and 
     privileged access to our taxpayer dollars.
           For Life,
         Marjorie Dannenfelser, President, Susan B. Anthony List; 
           Paul Weber, President & CEO, Family Policy Alliance; 
           Tom McClusky, Vice President, March for Life Action; 
           Frank Cannon, President, American Principles Project; 
           Clarke Forsythe, Acting President & Senior Counsel, 
           Americans United for Life Action; Penny Nance, CEO & 
           President, Concerned Women for America; Kristan 
           Hawkins, President, Students for Life; Lauren Muzyka, 
           Executive Director, Sidewalk Advocates for Life; 
           Melissa Ortiz, Able Americans; Eric Teetsel, President, 
           Family Policy Alliance of Kansas; Troy Newman, 
           President, Operation Rescue; Brian Fisher, Human 
           Coalition, President & Co-Founder.
         Maria McFadden Maffucci, Editor, Human Life Review; Matt 
           Lockett, Executive Director, Bound4LIFE International; 
           Roland C. Warren, President and CEO, Care Net; Judie 
           Brown, President, American Life League; Jim Sedlak, 
           Founder, STOPP International; Steven Ertelt, Editor, 
           LifeNews.com; Joe Ortwerth, Executive Director, 
           Missouri Family Policy Council; Denise Leipold, 
           Executive Director, Right to Life of Northeast Ohio; 
           Tami L. Fitzgerald, Executive Director, NC Values 
           Coalition; Jeanette Burdell, Executive Director, St 
           Joseph County Right To Life; Nicole Theis, President, 
           Delaware Family Policy Council; John Helmberger, Chief 
           Executive Officer, Minnesota Family Council; Chris 
           Slattery, Director, Expectant Mother Care-EMC FrontLine 
           Pregnancy Centers.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 123, the previous question is ordered on 
the joint resolution.
  The question is on the engrossment and third reading of the joint 
resolution.
  The joint resolution was ordered to be engrossed and read a third 
time, and was read the third time.

[[Page 2752]]

  The SPEAKER pro tempore. The question is on the passage of the joint 
resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Ms. DeGETTE. Madam Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

                          ____________________